My partner is on a combination of Scoctrin and Kaletra due to the presence of the T215 and M41L mutation. Two things seem to be happening. Acne has been popping up on his back neck and chest probably at a moderate level. They appear large and blind in most cases.

The other is very tender and swallon right shoulder. It appears muscular underneath his shoulde blade. There appears to be some swelling and strong pain when the shoulder is postioned in particular ways. Could both of these issues be side affects and if so should I worry?

Flare ups of acne can be seen in a minority of patients when starting effective HIV drugs partly due to immune reconstitution and possibly from an effect of drugs (such as protease inhibitors) on some hormone levels. Pain localized to the shoulder would rarely be due to either efavirenz or Kaletra. A full history and physical examination is important to sort out the possible causes of the shoulder pain and device an evaluation/treatment plan. Referral to a rheumatologist can often be helpful for shoulder pain. KH